Degree Family History Of Diabetes Research Articles

1392-P: Assisted Reproduction Technology Treatment and Risk of Gestational Diabetes

Assisted reproduction technology (ART) treatment has been suggested to increase the risk of gestational diabetes (GDM), though the nature of this association remains unclear. In the attempt to gain more insight in such an association we have carried out a study to evaluate whether ART represents an independent risk factor for GDM in single pregnancies. We collected retrospectively clinical and anthropometric data of 221 ART- and 256 age and BMI matched women with natural conception (NC) screened for GDM between 2011-2019. Out of 477 women, 32 were excluded from the analysis due to multiple pregnancies (PMA: 24; CN: 8). Between the two groups there were no differences in age (ART: 39 ± 5; NC: 38 ± 3 years; ns), BMI (ART: 23.6 ± 4.4; NC: 22.9 ± 3.6 Kg/m2; ns) and family history of diabetes (ART: 31.4%; NC: 24.2%; ns). ART-women were more frequently primiparous (62.6% vs. 22.6%; p<0.0001), while a higher prevalence of previous GDM was observed among NC-women (9.7% vs. 2.6%; p=0.002). The prevalence of GDM in the whole cohort was 36.1% and was significantly higher in women with ART (52.3% vs. 23.4%; p <0.0001). In the whole cohort, risk factors for GDM were: age (OR 1.07 95% CI 1.02-1.13), first degree family history of diabetes (OR 2.02 95% CI 1.31-3.10), previous GDM (OR 2.09 95% CI 1.39- 3.14), pre-pregnancy obesity (OR 3.28; 95% CI 1.57-6.86) and ART (OR 3.59; 95% CI: 2.39 - 5.39). On multivariate analysis, family history of diabetes (OR 1.67; 95% CI: 1.03-2.69), previous GDM (OR 7.05; 95% CI: 2.92-17.04); pre-pregnancy obesity (OR 2.72; 95% CI 1.21-6.13) and ART (OR 4.14; 95% CI 2.65-6.48) were independent risk factors for GDM . Among women requesting ART treatment, at least one in two develops GDM, and ART appears to be an independent risk factors for GDM. Disclosure C. Bianchi: None. C. Della Pelle: None. G. de Gennaro: None. M. Aragona: None. V. Cela: None. S. DelPrato: None. A. Bertolotto: None.

Diabetes in the Kokan region of India.

BACKGROUNDBKL Walawalkar Hospital is situated near the village of Dervan in the Kokan region of the state of Maharashtra in India. A survey of 2200 surrounding villages showed 51.8% adults had body mass index (BMI) below <18.5 kg/m2 and only 4.5% were overweight. A survey of 11521 adolescent girls from rural schools showed 64% prevalence of thinness. In the same region, government survey reported the prevalence of diabetes around 7%, and 70% prevalence of leanness. This reinforced the fact that the overall population of Kokan is lean. Hence, we decided to investigate body composition of diabetic people from our hospital clinic by carrying out a clinic-based case control study.AIMTo study body composition of diabetics in a rural clinic of Kokan.METHODSIn a case-control study, 168 type 2 diabetic patients (102 men) attending the outpatient department at a rural hospital and 144 non-diabetic controls (68 men) in the Chiplun area of the Kokan region were recruited. History of diabetes (age of onset, duration), anthropometric measurements (height, weight, waist and hip circumference) were recorded. Body composition was measured by bioimpedance using the TANITA analyzer.RESULTSMore than 45% of diabetic subjects had a 1st degree family history of diabetes, and more than 50% had macrovascular complications. The average BMI in diabetic subjects was 24.3 kg/m2. According to World Health Organization standards, prevalence of underweight was 8% and that of normal BMI was around 50%. Underweight and normal diabetic subjects (men as well as women) had significantly lower body fat percentage, higher muscle mass percentage, lower visceral fat and lower basal metabolic rate when compared to their overweight counterparts.CONCLUSIONThe diabetic population in Kokan has near normal body composition, and BMI has considerable limitations in assessing body composition and it also lacks sensitivity for assessing risk for diabetes in this population. High prevalence of family history of diabetes may point towards genetic predisposition. Leanness is an inherent characteristic of this population and its metabolic significance needs further investigations with a larger sample size.

Diabetic Complications among Follow-up Patients: A Cross-sectional Study at Jimma University Specialized Hospital Diabetic Clinic

Diabetes mellitus refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. Diabetic complications can be acute or chronic. Acute complications are Diabetic ketoacidosis and Hyperglycemic hyperosmolar state. This study aimed to assess the prevalence of diabetic complications with its associated factors among follow-up patients. A hospital based crosssectional study was conducted from July 27, to August 11, 2015 at Jimma University specialized hospital, Ethiopia. A total of 160 diabetic patients were included. The study was approved by the university ethical review board. Male to female ratio was 1.86:1, 58. 8% of the patients were from rural area and almost half (48.1%) have normal body mass index values. Majority (82%) of the patients were married and 28.2% of the study population were farmers. Type II diabetes was identified in 56.2%, while the rest were with Type I. Poly-symptoms was seen in 61.7% patients initially. Majority (77.5%) of them don’t have first and second degree family history of diabetes. Drug adherence, presence of infection and chronic medical conditions were the factors responsible for development of complications. A patient centered educational intervention needs to be done to reduce the complication among patients on follow-up.

Type 2 diabetes and glucose intolerance in a population with intellectual disabilities: the STOP diabetes cross-sectional screening study.

Adults with intellectual disabilities (ID) may be at increased risk of developing type 2 diabetes and cardiovascular disease, due to lifestyle factors, medications and other diagnosed conditions. Currently, there is lack of evidence on prevalence and prevention in this population. The aim of this study was to conduct a diabetes screening programme to determine prevalence of previously undiagnosed type 2 diabetes and impaired glucose regulation in people with ID. Screening was conducted in a variety of community settings in Leicestershire, UK. Adults with ID were invited via: general practices; the Leicestershire Learning Disability Register; ID psychiatric services; and some people directly contacted the research team due to publicity about the study. Screening involved collection of anthropometric, biomedical and questionnaire data. Type 2 diabetes and impaired glucose regulation were defined according to (venous) fasting plasma glucose or HbA1c, following current World Health Organisation criteria. Nine hundred thirty adults (29% of those approached) participated. Mean age was 43years, 58% were male and 16% of South Asian ethnicity. Most participants were either overweight or obese (68%). Diabetes status was successfully assessed for 675 (73%) participants: Nine (1.3%, 95% confidence interval 0.6 to 2.5) were found to have undiagnosed type 2 diabetes, and 35 (5.2%, 95% confidence interval 3.6 to 7.1) had impaired glucose regulation. Key factors associated with abnormal glucose regulation included the following: non-white ethnicity and a first degree family history of diabetes. Results from this large multi-ethnic cohort suggest a low prevalence of screen-detected (previously undiagnosed) type 2 diabetes and impaired glucose regulation in adults with ID. However, the high levels of overweight and obesity we found emphasise the need for targeted lifestyle prevention strategies, which are specifically tailored for the needs of people with ID.

Contribution of CDKAL1 rs7756992 and IGF2BP2 rs4402960 polymorphisms in type 2 diabetes, diabetic complications, obesity risk and hypertension in the Tunisian population 在突尼斯人群中，CDKAL1 rs7756992与IGF2BP2 rs4402960的多态性对2型糖尿病、糖尿病并发症、肥胖风险以及高血压的影响

The insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2) and the cyclin-dependent kinase 5 regulatory subunit-associated protein 1-like 1 (CDKAL1) identified through genome-wide association (GWA) studies have been shown to be associated with Type 2 diabetes in various ethnic groups. In this study, we investigated the association of the rs7756992 of CDKAL1 and the rs4402960 of IGF2BP2 with Type 2 diabetes, diabetic complications (nephropathy, retinopathy and cardiovascular disease), obesity and hypertension in a Tunisian population. A case-control association study including 200 Type 2 diabetes Tunisian patients (World Health Organization criteria) and 208 controls (age ≥40; fasting plasma glucose <6.1 mmol/L; without first degree family history of diabetes) has been performed. Other parameters such as diabetic nephropathy, diabetic retinopathy, cardiovascular disease, overweight/obesity and hypertension have been also collected. Genotyping was performed using TaqMan technology. A significant association between the rs4402960 and Type 2 diabetes (OR = 1.86, 95% CI = 1.34-2.58, P < 10(-4) ) has been found. Overweight/obese subjects bearing the T-allele have an increased risk to develop Type 2 diabetes (OR = 2.06, 95% CI = 1.40-3.03, P < 10(-4) ). Furthermore, the rs7756992 was found to be associated with the reduced risk of diabetic nephropathy in patients with diabetes (OR = 0.44, 95% CI = 0.27-0.73, P = 0.001). The present study confirms that the rs4402960 of IGF2BP2 gene is a strong candidate for Type 2 diabetes susceptibility and overweight/obesity risk in the Tunisian population. Interestingly, our data suggest that the rs7756992 of CDKAL1 gene have a protective effect against diabetic nephropathy.

Grand challenges in diabetes.

Grand challenges in diabetes.

The Leicester Risk Assessment score for detecting undiagnosed Type 2 diabetes and impaired glucose regulation for use in a multiethnic UK setting

Risk assessment scores identify those at high risk of impaired glucose regulation and Type 2 diabetes mellitus. To date no risk assessment scores that can be completed by a lay person have been developed and validated specifically for multiethnic populations in the UK. We used data on 6186 subjects aged 40-75 years from a multiethnic UK screening study (73% white European, 22% South Asian). All participants were given a 75 g oral glucose tolerance test. We developed logistic regression models for predicting current impaired glucose regulation (impaired fasting glycaemia/impaired glucose tolerance) or Type 2 diabetes mellitus using data from anthropometric measurements and self-reported questionnaires. Using the best-fitting model, we developed the Leicester Risk Assessment score. We externally validated the score using data from 3171 subjects aged 40-75 years from a separate screening study. The components of the final model are age, ethnicity [white European vs. other (predominantly South Asian)], sex, first degree family history of diabetes, antihypertensive therapy or history of hypertension, waist circumference and body mass index. The score ranges from 0 to 47. Validating this model using the data from the second screening study gave an area under the receiver operator characteristic curve of 72% (95% confidence interval, 69-74%). A cut point of 16 had a sensitivity of 81% and a specificity of 45%. The Leicester Risk Assessment score can be used to identify those at high risk of impaired glucose regulation and Type 2 diabetes mellitus in UK multiethnic populations. The score is simple (seven questions) and non-invasive.

The prevalence and expression of diabetes in a sample of optometric patients

The clinical characteristics of 100 consecutively presenting diabetic patients of an optometrist were investigated. This sample was drawn from 3798 patient first visits and represented 2.6% of the practice population sample. Diabetic retinopathy was present in 26% of the diabetic patients; this prevalence is similar to that found in diabetics examined in community based surveys. The ocular complications of diabetics observed in this study appeared to be similar to those of diabetics in the general community. The mean random blood glucose levels of the diabetics having retinopathy was not significantly different from those not having retinopathy. A first degree family history of diabetes was admitted by 46% of the diabetic subjects and was the most common associated clinical feature surveyed; a control group of non-diabetic subjects had a first degree family history of diabetes in 10% of cases. In seven patients, the diabetes was diagnosed as a result of signs detected at the optometric examination; these signs are listed. No newly diagnosed diabetic had diabetic retinopathy as a presenting sign. Ocular and systemic signs, other than diabetic retinopathy, were sought and a high prevalence of cardiovascular disease was detected in these diabetic patients. The vision of the diabetic patients was compared to that of 100 randomly selected age and sex matched controls; there was no significant difference in the visual acuity of the two groups. The implications of this finding are discussed. Guidelines for the detection and management of diabetic patients of optometrists are suggested.

First degree family history of diabetes and risk factors for cardiovascular disease in non-diabetic subjects in the National Telephone Company: a metabolic survey.

The effect of first degree family history of diabetes on known risk factors for cardiovascular disease was evaluated in 4989 non-diabetic employees of the Italian Telephone Company. Family history of diabetes was present in 759 subjects (476 males and 283 females); in these subjects body mass index, diastolic blood pressure, blood glucose levels (fasting and one and two-hour post-load), triglyceride and cholesterol levels were significantly higher than in age and sex-matched controls. In different age groups (less than 30, 31-40, 41-50, greater than 50 years) the effect of first degree family history of diabetes was evaluated after stratification by sex. In males with first degree family history of diabetes, this effect was strongest in the under 30 age group: body mass indices, systolic and diastolic blood pressures, fasting and two-hour post-load blood glucose levels, triglyceride and cholesterol levels were all significantly higher than in subjects with negative family history of diabetes. These differences between subjects with negative and positive family histories declined with age and disappeared in subjects over 50. In females the effect of familial diabetes was weaker and delayed for body mass index and one hour blood glucose, appearing only in subjects over 30. Multiple logistic analysis indicated that only body mass index and one-hour blood glucose levels were independently associated with positive family history of diabetes. The differences observed between males and females in the youngest age group were also confirmed by this analysis. These data may indicate a multifactorial genetic link leading to increased cardiovascular morbidity in subjects with diabetes.

Characterization of Patients with Chlorpropamide‐Alcohol Flush

One hundred and sixty patients with onset of non-ketotic diabetes at the ages of 35-70 were investigated for chlorpropamide-alcohol flush (CPAF), beta-cell function, insulin sensitivity, human leucocyte antigens (HLA), organ specific antibodies and diabetic complications. A positive flush reaction was defined as an increase in facial skin temperature by at least 1.5 degrees C, which was associated with a visible flush reaction in all patients. In accordance with these criteria, 38% of the patients were considered CPAF-positive with a mean rise in facial skin temperature of 2.3 +/- 0.1 degrees C compared with 0.6 +/- 0.1 degrees C in the CPAF-negative patients (p less than 0.001). The CPAF-positive patients could be distinguished from the CPAF-negative with respect to: 1) higher frequency of first degree family history of diabetes (p less than 0.05), 2) lower basal and glucagon-stimulated C-peptide concentrations (p less than 0.02 and p less than 0.001), 3) increased frequency of HLA-A2 (p less than 0.01) and decreased frequency of HLA-B7 (p less than 0.01). The findings thus support the genetically determined nature of CPAF. Considering the criteria for maturity onset diabetes in the young, it is unlikely that CPAF acts as a genetic marker for this particular form of genetic diabetes.

Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes.

Seventy patients with non-insulin dependent diabetes (NIDD) were studied for the chlorpropamide-alcohol flush (CPAF), first degree family history of diabetes, macroangiopathy and for peripheral neuropathy. Positive CPAF challenge tests were found in 65% of the tested subjects and in 77% if there was a family history of diabetes. Signs of macroangiopathy (loss of foot pulses) were significantly (p less than 0.05) less common in the CPAF positive than in the CPAF negative diabetics with a duration of diabetes of ten years or less. With a longer duration this difference between the two groups was reduced. Also signs of peripheral neuropathy (abnormal vibration sense) were less common (p less than 0.05) in the CPAF positive diabetics than in the CPAF negative. Previously a low prevalence of retinopathy in teh CPAF positive non-insulin dependent diabetics has been reported. We have shown that this is also true of peripheral macroangiopathy and peripheral neuropathy. Chlorpropamide-alcohol flushing seems to be related to a relative protection against late complications in diabetes and the test might be used to find patients at risk.